US6200279B1 - Method and apparatus monitoring the progress of labor - Google Patents
Method and apparatus monitoring the progress of labor Download PDFInfo
- Publication number
- US6200279B1 US6200279B1 US09/072,850 US7285098A US6200279B1 US 6200279 B1 US6200279 B1 US 6200279B1 US 7285098 A US7285098 A US 7285098A US 6200279 B1 US6200279 B1 US 6200279B1
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- United States
- Prior art keywords
- mother
- location
- presenting part
- position sensor
- cervix
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
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- 0 C*OC1C=*CC1 Chemical compound C*OC1C=*CC1 0.000 description 2
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
- A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
- A61B5/1076—Measuring physical dimensions, e.g. size of the entire body or parts thereof for measuring dimensions inside body cavities, e.g. using catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/43—Detecting, measuring or recording for evaluating the reproductive systems
- A61B5/4306—Detecting, measuring or recording for evaluating the reproductive systems for evaluating the female reproductive systems, e.g. gynaecological evaluations
- A61B5/4343—Pregnancy and labour monitoring, e.g. for labour onset detection
- A61B5/435—Assessing cervix alteration or dilation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
- A61B8/0866—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving foetal diagnosis; pre-natal or peri-natal diagnosis of the baby
Definitions
- the present invention relates to a method and apparatus for monitoring the progress of labor during childbirth.
- the first stage begins with the onset of labor and ends when dilatation of the cervix is complete; the second stage begins at that point and ends with the complete birth of the baby; and this is followed by the third stage which ends with the delivery of the placenta.
- labor it is common to use either an external ultrasonic system for recording the baby's heart rate, and an external system for detecting the mother's uterine contractions, or an electronic system to sense the baby's heart pulses by an electrode attached to the baby's head and the mother's contractions by a pressure catheter applied to the mother inside the uterus.
- the more common determination of station is the distance between the tip of the fetal head and the ischial spines which can be palpable by the physician; but a more accurate determination of station is the distance between the bi-parietal diameter (BPD) of the fetal head and the mother's pelvic inlet.
- BPD bi-parietal diameter
- the foregoing conditions are generally determined by a physical examination, i.e., by the insertion of a finger through the mother's vagina.
- a physical examination i.e., by the insertion of a finger through the mother's vagina.
- the accuracy of such a “finger” examination is very subjective and depends to a great extent on the experience, judgment, and even finger size, of the physician.
- Other drawbacks in such a physical examination are that it can be done only at spaced intervals, it generally produces discomfort to the mother, and it involves a number of risks including contamination, infection, dislodgment of a fetal monitor, injury to the baby, etc. Failure to interpret the precise stage of the labor progress from the physical examination can result in injury or even death of the baby or of the mother.
- U.S. Pat. No. 4,476,871 proposes an elongated tube having electrodes spaced along its length to monitor cervical dilatation during labor
- U.S. Pat. Nos. 4,942,882 and 5,135,006 propose a fetal monitor probe attached to the fetal head to monitor heart beat, which probe is calibrated to monitor progress of descent
- U.S. Pat. No. 5,222,485 proposes an elongated inflatable sac to monitor the position of the fetus and the configuration of the cervix
- U.S. Pat. No. 5,406,961 proposes a pessary to monitor the configuration of the cervix.
- none of the previously proposed devices has come into any widespread uses and the historical “finger” examination continues to be the one in common use to this day.
- An object of the present invention is to provide a method and apparatus having advantages over the conventional “finger” examination technique for monitoring the progress of labor in a mother during childbirth.
- a method of monitoring the progress of labor in a mother during childbirth comprising: attaching a position sensor to a predetermined point on the mother's pelvic bones; monitoring the location of the position sensor in three-dimensional space relative to a reference; and monitoring the location of the fetal presenting part with respect to the predetermined point on the mother's pelvic bones to provide an indication of the progress of labor.
- the location of the fetal presenting part, and also of the opposite sides of the end of the mother's uterine cervix are monitored by position sensors attached to these respective elements.
- the latter are monitored by operating an ultrasonic transducer to image the mother's cervix and pelvic bones, and the fetal head, on a screen, and by using a position sensor on the ultrasonic transducer, and a marker for marking the screen, to locate the positions of these elements.
- a third embodiment is described utilizing both the four position sensors applied to the mother and the fetal presenting part, and a fifth position sensor applied to an ultrasonic transducer for imaging and locating the mother's cervix and pelvic bones and the fetal head
- the cervical dilatation of the mother's cervix is continuously indicated by continuously monitoring the positions of the position sensors applied to the opposite sides of the end of the cervix, and continuously displaying the spatial distance between them.
- the position of the fetal presenting part e.g., fetal head
- the above conditions are computed and displayed in the form of units of distance (e.g., cm), and/or in the form of a graph, called a Partogram, showing the interrelation of the cervical dilatation and the descent of the fetal presenting part
- apparatus for monitoring the progress of labor in a mother during childbirth comprising: a position sensor for attachment to a predetermined point on the mother's pelvic bones, and for producing an output signal identifying its location in space; means for sensing the location of the fetal presenting part with respect to the predetermined point on the mother's pelvic bones, and for producing an output signal identifying the location of the fetal presenting part; a computer connected to receive the output signals; and an output device controlled by the computer for outputting the position of the fetal presenting part with respect to the predetermined point of the mother's pelvic bones
- the output device is preferably a display, but could be a plotter, recorder, or other device for displaying, recording, and/or processing the data outputted by the computer
- such a method and apparatus permits the progress of labor to be monitored in a manner which is continuous rather than intermittent, which is less dependent for accuracy on the experience, judgment or finger size of the attendant in the conventional “finger examination”, which subjects the mother to less discomfort, and which involves less risk of contamination, infection, dislodgment of a fetal monitor, or injury to or death of the baby or mother due to a wrong assessment of the fetal position or of labor progress.
- this technique enables more precise monitoring of the critical condition, namely the changes in the spatial distance of the BPD of the baby's head with respect to the pelvic inlet
- FIG. 1 is a block diagram illustrating one form of system constructed in accordance with the present invention
- FIG. 2 illustrates one of the position sensors in the system of FIG. 1;
- FIG. 3 is a block diagram of one type of position sensor system that may be used
- FIG. 4 more particularly illustrates the Partogram display in the system of FIG. 1;
- FIG. 5 is a block diagram illustrating an imaging system for displaying the image of the mother's womb, particularly the cervix, pelvic bones, and the fetal head to better show the progress of the labor;
- FIGS. 6A-6D illustrate typical displays produced by the system of FIG. 5 during the various stages of labor
- FIG. 7 illustrates a typical display produced by the system of FIG. 5 during the descent of the fetal head
- FIG. 8 illustrates how the monitored data may be processed to display the changes in the spatial distance of the BPD of the baby's head with respect to the mother's pelvic inlet
- FIG. 9 illustrates a fetal heart monitoring display and uterine contractions that may be included in the above-described systems of FIG. 1 or FIG. 5 .
- FIG. 1 schematically illustrates the mother's womb particularly illustrated in FIG. 4, is of special value since it provides a visual display of the progress of labor and can be recorded if desired.
- Partogram By using the Partogram, a better determination can be made whether labor is progressing normally. “Alert” and “action” lines may be printed on the Partogram to provide a visible indication of whether labor is progressing normally or abnormally, and thereby to better alert the attending personnel to take prompt action if necessary.
- Such an “electronic Partogram” can also markedly reduce the number of prolonged labors, the rate of intrapartum, post partum and early neonatal infections, the number of unnecessary interventions, and neonatal trauma due to wrong assessment of the fetal head.
- FIG. 5 illustrates a monitoring system similar to that of FIG. 1 but further equipped with an imaging system for imaging the womb area of the mother and for continuously displaying the mother's cervix, pelvic bones, and fetal head (or other presenting part).
- FIG. 5 includes an ultrasonic transducer 40 for imaging the womb area, via the computer 12 , on an image display 42 . It also includes a position sensor PS 5 attached to the ultrasonic transducer 40 .
- a marker device 43 such as a mouse or touch screen
- the computer 12 can compute the various relationships displayed in displays 14 and 16 , thereby obviating the need for the positions sensors PS 2 , PS 3 and PS 4 .
- the image displayed in display 42 may be used in the same manner for marking the BPD on the fetal head as illustrated in FIG. 8, thereby enabling particularly the spatial distance between the fetal BPD and the pelvic inlet to be computed and monitored.
- reference points other than the BPD or the tip of the fetus head, as well as any other point of the mother's pelvis, may be used as the reference points for monitoring the progress of the labor. This freedom is important because of the variety of preferences among various physicians.
- the imaging system illustrated in FIG. 5 could also be used to provide a visual image of the various stages of labor, e.g., as illustrated in FIGS. 6A-6D showing the progressive dilatation and effacement of the cervix, or as illustrated in FIGS. 7 and 8 showing the progressive descent of the fetal head tip through the various stations with respect to the ischial spines 7 (FIG. 7) or mother's pelvic inlet (FIG. 8 ).
- the ultrasound imaging may be used only to measure the BPD at the beginning of labor or later.
- the computer determines the distance between the BPD and the tip of the fetal head, and thereafter it can use the position of the tip of the fetal head also to determine the BPD position.
- the ultrasound imaging may thereafter be used only for verification if desired. It can also be used to verify cervical dilatation and effacement.
- the monitoring would preferably not be continuous but only intermittent, i.e., only when it is desired to monitor a specific stage in the progress of the labor.
- the system illustrated in FIG. 5 may also be used for sensing contractions in the mother's uterus.
- the fetal head moves slightly, and the dilatation also grows slightly; and after contractions, they both retract to their previous positions.
- the attending physician may discern the occurrence of contractions as well as the duration and strength of such contractions.
- the physician may observe the relation of the fetal heart rate (FHR) in relation to the uterine contractions (UC), to show the relationship between the two as illustrated in FIG. 9 .
- Computer 12 may be programmed to receive the above information from the various sensors and produce, in a monitor 45 , a display corresponding to the fetal heart rate (FHR) in relation to the uterine contractions (UC), as illustrated in FIG. 9 .
- FHR fetal heart rate
- UC uterine contractions
Abstract
Description
Claims (36)
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/072,850 US6200279B1 (en) | 1997-05-05 | 1998-05-05 | Method and apparatus monitoring the progress of labor |
US10/289,304 US6669653B2 (en) | 1997-05-05 | 2002-11-07 | Method and apparatus for monitoring the progress of labor |
US10/534,084 US20060015036A1 (en) | 1997-05-05 | 2003-11-06 | Method and apparatus for monitoring the progress of labor |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US4555697P | 1997-05-05 | 1997-05-05 | |
US09/072,850 US6200279B1 (en) | 1997-05-05 | 1998-05-05 | Method and apparatus monitoring the progress of labor |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
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US69856800A Continuation | 1997-05-05 | 2000-10-27 |
Publications (1)
Publication Number | Publication Date |
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US6200279B1 true US6200279B1 (en) | 2001-03-13 |
Family
ID=21938597
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/072,850 Expired - Lifetime US6200279B1 (en) | 1997-05-05 | 1998-05-05 | Method and apparatus monitoring the progress of labor |
Country Status (15)
Country | Link |
---|---|
US (1) | US6200279B1 (en) |
EP (1) | EP1006882B1 (en) |
JP (1) | JP3474584B2 (en) |
KR (1) | KR100555353B1 (en) |
CN (2) | CN100387191C (en) |
AT (1) | ATE449568T1 (en) |
AU (1) | AU733125B2 (en) |
BR (1) | BR9808723B1 (en) |
CA (1) | CA2289551C (en) |
DE (1) | DE69841312D1 (en) |
ES (1) | ES2337425T3 (en) |
IL (1) | IL132703A (en) |
RU (1) | RU2225165C2 (en) |
UA (1) | UA65566C2 (en) |
WO (1) | WO1998049942A1 (en) |
Cited By (26)
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WO2002098271A2 (en) | 2001-06-05 | 2002-12-12 | Barnev Ltd. | Birth monitoring system |
US20040089308A1 (en) * | 2002-11-13 | 2004-05-13 | Welch Robert A. | Cervical ring to deliver medication |
US20060015036A1 (en) * | 1997-05-05 | 2006-01-19 | Yoav Paltieli | Method and apparatus for monitoring the progress of labor |
US7008292B2 (en) * | 2000-05-11 | 2006-03-07 | Luca Nardi | Structure for supporting body parts of the human body |
US20060282019A1 (en) * | 2005-06-07 | 2006-12-14 | Lms Medical Systems, Ltd. | Method and apparatus for providing information related to labor progress for an obstetrics patient |
US20070156068A1 (en) * | 2005-12-29 | 2007-07-05 | Intrapartum Ventures, Llc; | Cervimetry control apparatus |
US20070213640A1 (en) * | 2006-02-26 | 2007-09-13 | Hebah Noshy Mansour | Measurement aid for digital cervix examination |
US20070239197A1 (en) * | 2006-04-10 | 2007-10-11 | Intrapartum Ventures, Llc | Method for cervical dilation and/or measurement |
US20070255185A1 (en) * | 2005-12-29 | 2007-11-01 | Intrapartum Ventures, Llc. | Cervical dilation measurement apparatus |
US20080039744A1 (en) * | 2006-05-01 | 2008-02-14 | Lms Medical Systems Ltd. | Method and apparatus for providing contraction information during labour |
US20080167553A1 (en) * | 2003-08-06 | 2008-07-10 | Yoav Paltieli | Method and Apparatus For Monitoring Labor Parameter |
US20080167581A1 (en) * | 2007-01-10 | 2008-07-10 | Yoav Paltieli | Determining parameters associated with a female pelvis and cervix |
US20100049094A1 (en) * | 2008-08-18 | 2010-02-25 | O'brien John M | Cervical dilation meter |
US20100268124A1 (en) * | 2007-12-10 | 2010-10-21 | Emily Hamilton | Method and apparatus for providing contraction information during labour |
WO2011032065A1 (en) | 2009-09-13 | 2011-03-17 | Trig Medical Ltd. | Birth delivery device with position sensor |
US20110190580A1 (en) * | 2009-09-28 | 2011-08-04 | Bennett James D | Analysis engine within a network supporting intravaginal monitoring |
US20120179045A1 (en) * | 2011-01-07 | 2012-07-12 | General Electrical Company | Fetal Scalp Doppler Device and System |
US20140276918A1 (en) * | 2013-03-14 | 2014-09-18 | Plexus Biomedical, Inc. | Labor Management Methods for Decreasing the Duration of Second Stage Labor |
US20160045152A1 (en) * | 2014-08-12 | 2016-02-18 | General Electric Company | System and method for automated monitoring of fetal head descent during labor |
US20160081663A1 (en) * | 2014-09-18 | 2016-03-24 | General Electric Company | Method and system for automated detection and measurement of a target structure |
US9795298B2 (en) | 2011-12-13 | 2017-10-24 | Einnovations Holdings Pte. Ltd. | System and method for transmitting, receiving and analysing partograph information |
US9892475B1 (en) | 2006-11-03 | 2018-02-13 | E&C Medical Intelligence, Inc. | System and method for interactive clinical support and compliance with clinical standards and guidelines in real-time |
US10368833B2 (en) | 2014-09-12 | 2019-08-06 | General Electric Company | Method and system for fetal visualization by computing and displaying an ultrasound measurement and graphical model |
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US10854332B2 (en) | 2006-05-01 | 2020-12-01 | Perigen, Inc. | Method and apparatus for providing contraction information during labour |
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US6270458B1 (en) * | 1999-03-05 | 2001-08-07 | Barnev Inc. | Cervix dilation and labor progression monitor |
US6423016B1 (en) * | 2000-06-08 | 2002-07-23 | Lms Medical Systems Ltd. | System and method for evaluating labor progress during childbirth |
US20090093716A1 (en) * | 2007-10-04 | 2009-04-09 | General Electric Company | Method and apparatus for evaluation of labor with ultrasound |
IT1391829B1 (en) * | 2008-11-21 | 2012-01-27 | C N R Consiglio Naz Delle Ricerche | EQUIPMENT BASED ON ULTRASOUNDS TO MEASURE PARAMETERS ADVANCEMENT INDICATORS OF A PARTY |
US9131860B2 (en) | 2008-12-29 | 2015-09-15 | Mark Evans | Identifying the level of fetal risk during labor |
US9107584B2 (en) * | 2010-08-02 | 2015-08-18 | Koninklijke Philips N.V. | Method of reducing ultrasound signal ambiguity during fetal monitoring |
US9972219B2 (en) | 2012-04-30 | 2018-05-15 | Laerdal Global Health As | Postpartum uterus model |
US20160278688A1 (en) * | 2012-11-26 | 2016-09-29 | Ferring B.V. | Method and System for Diagnosing Uterine Contraction Levels Using Image Analysis |
CN104000656B (en) * | 2014-05-08 | 2016-03-23 | 朱秀红 | Delivery of fetus processor |
KR102356719B1 (en) * | 2014-12-01 | 2022-01-27 | 삼성메디슨 주식회사 | ULTRASOUND IMAGE APPARATUS AND operating method for the same |
BR112018010832A2 (en) * | 2015-11-30 | 2018-11-21 | Koninklijke Philips Nv | fetal position monitoring system, and method for fetal position monitoring |
US11786169B2 (en) | 2016-11-21 | 2023-10-17 | Mark Evans | System, apparatus, and method for monitoring and assessing the level of fetal risk during labor |
US10595792B2 (en) * | 2017-06-11 | 2020-03-24 | Fetal Life Llc | Tocodynamometer GPS alert system |
CN110141272A (en) * | 2018-02-14 | 2019-08-20 | 王幼萍 | A kind of pelvis measuring and calculating devices and methods therefor |
CN109171910A (en) * | 2018-07-26 | 2019-01-11 | 佟玲 | A kind of obstetrics' sucker midwifery device |
WO2020102524A1 (en) * | 2018-11-14 | 2020-05-22 | Mark Evans | Method and apparatus for reducing the risk of neonatal neurological injury |
CN110400510B (en) * | 2019-07-31 | 2021-12-07 | 中国人民解放军陆军军医大学第一附属医院 | Evaluation device for pregnant and lying-in woman birth canal simulation training detection result |
WO2022025062A1 (en) * | 2020-07-28 | 2022-02-03 | 国立大学法人東京大学 | Labor progress state evaluation device, labour progress state evaluation method, and program |
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- 1998-05-04 CA CA2289551A patent/CA2289551C/en not_active Expired - Fee Related
- 1998-05-04 ES ES98919447T patent/ES2337425T3/en not_active Expired - Lifetime
- 1998-05-04 AU AU72306/98A patent/AU733125B2/en not_active Ceased
- 1998-05-04 CN CNB2004100899837A patent/CN100387191C/en not_active Expired - Fee Related
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- 1998-05-04 EP EP98919447A patent/EP1006882B1/en not_active Expired - Lifetime
- 1998-05-04 KR KR1019997010191A patent/KR100555353B1/en not_active IP Right Cessation
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Cited By (58)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20060015036A1 (en) * | 1997-05-05 | 2006-01-19 | Yoav Paltieli | Method and apparatus for monitoring the progress of labor |
US7008292B2 (en) * | 2000-05-11 | 2006-03-07 | Luca Nardi | Structure for supporting body parts of the human body |
WO2002098271A2 (en) | 2001-06-05 | 2002-12-12 | Barnev Ltd. | Birth monitoring system |
EP1420697A2 (en) * | 2001-06-05 | 2004-05-26 | Barnev Ltd. | Birth monitoring system |
US20040153008A1 (en) * | 2001-06-05 | 2004-08-05 | Yehuda Sharf | Probe anchor |
US20040236193A1 (en) * | 2001-06-05 | 2004-11-25 | Yehuda Sharf | Birth monitoring system |
US7207941B2 (en) | 2001-06-05 | 2007-04-24 | Barnev Ltd. | Birth monitoring system |
EP1420697A4 (en) * | 2001-06-05 | 2007-05-30 | Barnev Ltd | Birth monitoring system |
US20040089308A1 (en) * | 2002-11-13 | 2004-05-13 | Welch Robert A. | Cervical ring to deliver medication |
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JP3474584B2 (en) | 2003-12-08 |
BR9808723A (en) | 2000-07-11 |
ES2337425T3 (en) | 2010-04-23 |
CA2289551A1 (en) | 1998-11-12 |
CN1631322A (en) | 2005-06-29 |
EP1006882B1 (en) | 2009-11-25 |
BR9808723B1 (en) | 2011-10-18 |
UA65566C2 (en) | 2004-04-15 |
JP2001504380A (en) | 2001-04-03 |
IL132703A0 (en) | 2001-03-19 |
CN100482158C (en) | 2009-04-29 |
KR100555353B1 (en) | 2006-02-24 |
EP1006882A1 (en) | 2000-06-14 |
CN1261260A (en) | 2000-07-26 |
KR20010012241A (en) | 2001-02-15 |
DE69841312D1 (en) | 2010-01-07 |
CA2289551C (en) | 2010-12-14 |
AU733125B2 (en) | 2001-05-10 |
RU2225165C2 (en) | 2004-03-10 |
AU7230698A (en) | 1998-11-27 |
CN100387191C (en) | 2008-05-14 |
EP1006882A4 (en) | 2000-08-02 |
WO1998049942A1 (en) | 1998-11-12 |
IL132703A (en) | 2004-08-31 |
ATE449568T1 (en) | 2009-12-15 |
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